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Association between acute geriatric syndromes and medication-related hospital admissions

Wierenga, P. C., Buurman, B. M., Parlevliet, J. L., van Munster, B. C., Smorenburg, S. M., Inouye, S. K. & de Rooij, S. E. J. A., 2012, In : Drugs & Aging. 29, 8, p. 691-699 9 p.

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  • Association between Acute Geriatric

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DOI

Background: Elderly patients are at a 4-fold higher risk of adverse drug events (ADEs) and drug-related hospitalization. Hospitalization of an elderly patient is often preceded by geriatric syndromes, like falls or delirium.

Objectives: The primary aim of this study was to investigate whether geriatric syndromes were associated with ADEs in acutely admitted elderly patients.

Methods: Consecutive medical patients, aged 65 years or more, who were acutely admitted, were enrolled. An initial multidisciplinary evaluation was completed and baseline characteristics were collected. A fall before admission was retrieved from medical charts. Delirium was determined by the Confusion Assessment Method.

Results: A total of 641 patients were included. Over 25% had an ADE present at admission, 26% presented with delirium and 12% with a fall. Delirium was associated with the use of antidepressants, antipsychotics and antiepileptics. In all ADEs (n = 167), ADEs were associated with a fall, with non-steroidal anti-inflammatory drugs or diuretics, but not with pre-existing functioning, delirium or older age. For ADEs involving psychoactive medication (n = 35), an association was found between delirium, falls, opioids and antipsychotics in bivariate analyses. A fall just before hospitalization (odds ratio [OR] 3.69 [95% Cl 1.41, 9.67]), antipsychotics (OR 3.70 [95% CI 1.19, 11.60]) and opioids (OR 14.57 [95% CI 2.02, 105.30]) remained independently associated with an ADE involving psychoactive medication.

Conclusion: This prospective study demonstrated that, in a cohort of elderly hospital patients, a fall before admission and prevalent delirium are associated with several pharmacological groups and/or with ADE-related hospital admission.

Original languageEnglish
Pages (from-to)691-699
Number of pages9
JournalDrugs & Aging
Volume29
Issue number8
Publication statusPublished - 2012
Externally publishedYes

    Keywords

  • ADVERSE DRUG EVENTS, ELDERLY EMERGENCY, OLDER PERSONS, RISK-FACTORS, DELIRIUM, PREVALENCE, ILLNESS, IQCODE

ID: 34072541